The financial implications of the US measles outbreaks

Earlier today, the CDC released a report about the measles outbreaks that have been occurring across the country since the beginning of the year. (Hat tip to USA Today‘s Liz Szabo for this story.) I wrote a fair amount about measles in my book, and one reason measles outbreaks are so scary (and so difficult to contain) is that measles is the most infectious microbe known to man–it’s transmission rate is around 90 percent. It has also killed more children than any other disease in history.

If you’re skeptical about the correlation between measles vaccination rates and the spread of the disease, or about the danger deliberately unvaccinated members of the population pose to infants, you should check out the CDC’s figures. They’re pretty stunning:

* There have been 118 reported measles cases in the first nineteen weeks of the year — which is the highest number of infections for that period since 1996. That’s particularly noteworthy because, as the CDC points out, “as a result of high vaccination coverage, measles elimination (i.e., the absence of endemic transmission) was achieved in the United States in the late 1990s and likely in the rest of the Americas since the early 2000s.”

* Eighty-nine percent of all reported cases have been in people who’ve been unvaccinated. Almost 20 percent of that figure is made up of children who were less than a year old. That means they were too young to have received the first dose of the measles-mumps-rubella (MMR) vaccine, which is given once between the ages of twelve and fifteen months and again when a child is between four and six years old. Another twenty percent of the total number of reported infections were in children between the ages of one and four.

* Forty percent of the infections recorded so far this year have resulted in hospitalization — and 98 percent of the people who were hospitalized were unvaccinated. In its typically understated manner, the CDC noted that “nine [of the hospitalized patients] had pneumonia, but none had encephalitis and none died”– which is another way of saying that encephalitis and death are potential complications of serious cases of pneumonia.

The most significant factor in the spread of measles in the United States is the increase of pockets of the country where vaccination rates have declined below the level needed to maintain herd immunity`– and, similar to what occurred in the UK in the early part of the last decade, that decline can be traced back to the press-fueled panic sparked by anti-vaccine messiah Andrew Wakefield’s discredited, retracted, and possibly fraudulent twelve-child case study linking the MMR vaccine to autism.

Anyone curious about how quickly a series of small measles conflagrations can spread horribly out of control should check out the situation currently unfolding in France, which is in the third year of a nation-wide outbreak.^ In 2007, the number of reported cases in France was around forty. The next year, they jumped to six hundred…and they’ve been rising ever since. So far in 2011, there have been more than 6,400 infections in the country. Translated to a population the size of the US’s, that would represent a jump from 188 cases to more than 28,000.

The toll that would take on the nation’s health-care infrastructure is mind-boggling. Consider this: In 2008, a deliberately unvaccinated patient of “Dr. Bob” Sears caught measles while on vacation in Switzerland. That single infection ultimately resulted in a total of 12 cases…and the total cost of containing the outbreak topped $150,000.

FOOTNOTES` The beginning of this sentence had previously read, “The most significant factor in the spread of measles in the United States is declining vaccination rates.” As some readers have pointed out, the overall vaccination rates in the country have more or less stayed the same; the issue is the increase in individual communities where vaccine refusal has grown.

^ France also illustrates how the result of vaccine panics can be similar even when the roots causes are completely unrelated: A recent British Medical Journal story titled “Outbreak of measles in France shows no signs of abating” points out that “the publication in the Lancet in 1998 of the research article by Andrew Wakefield purporting to show a link between the MMR vaccine and autism had no significant effect on uptake of the MMR vaccine in France. The main vaccine controversy in France has centred on that against hepatitis B, and this has taken its toll on immunisation campaigns as a whole.”

92 Responses to The financial implications of the US measles outbreaks

We told you so, anti-vaxxers. It was just a matter of time until the damage became apparent.

As nice as this data-filled report is, though–it’s still clear that data and facts have little value in this debate. They have *anecdotes*. Of course, one should make all medical decisions on anecdotes. Especially those written on the internetz.

That is a very specific number, but I cannot find it when searching the CDC website. Could you be so kind to actually post the link? Because I am getting the feeling that you made it up for your rather cryptic comment.

This is based on my anecdotal observations, not on any rigorous study.

Many women who can afford to stay home gave up careers to do so. Larger society undervalues stay-home moms (as well as teachers and other child care workers). So bright, educated women find themselves in clusters, isolated from prestige, and they bring the work ethic and focus that advanced them in careers to parenting. They must seek status and validation from other members of the stay-home community, and this requires separating themselves from the unwashed masses. (My friend calls this “competitive parenting.”)

This subculture fosters increasing intensity and extremism, and practices that might have begun as reasonable choices are pushed to extremes. Once everyone in the group is breastfeeding infants, for example, the higher-status women are the ones who breastfeed kindergartners.

This trajectory translates to increasingly harmful cultural norms. Once everyone treats vaccination as an ala carte menu, the higher-status women are the ones who are rejecting vaccines, or rejecting prenatal care, or obstetrical care, or whatever. Statistics are such that the individual mothers and children are likely to be unharmed by these decisions, and this leads to strong confirmation bias.

It would be interesting to do a formal study of vaccine-rejecting families vs. vaccine-delaying families vs. vaccine-adopting families, to determine the influences on decisions.

The article claims that the most significant factor in the spread of measles in the United States is declining vaccination rates. The claim is false since the rates aren’t declining.

Due to population growth and a stable vaccination rate, there are greater numbers of unvaccinated people in the US today, but are they clustered to a greater extent than they were in the past? Is there evidence of this?

The Oregon Live article was all about the schools where there are clusters of unvaccinated children, like the Waldorf schools (such as this case in Germany).

Plus measles is so infectious it can infect others with a short exposure, especially if the infectious person goes to a waiting room where there are children too young to be vaccinated. Here is an analysis of what happened in San Diego, where not only did the index case infect in siblings, and some students in his charter school who were not vaccinated, but also babies in a doctor’s waiting room.

Here is yet another analysis of a measles outbreak associated with a church group in Indiana. Another pair of churches in Philadelphia had a very high numbers of measles cases and deaths about twenty years ago:http://www.ncbi.nlm.nih.gov/pubmed/8483622

I know it is not in any PubMed cite, but about ten years ago there was an outbreak of measles in a private secondary school not far from where we live. It prompted me to get my younger children their second MMR vaccine a bit early. It was not long after that it was advised that kids get their second one before kindergarten. Since they were in 1st and 4th grade I did not think that would be a problem. And I would prefer to avoid them getting exposed by an infectious person just by being in the same grocery store or library.

Chris and Mary, I don’t doubt that there are groups with low vaccination rates or that such groups are at greater risk for outbreaks. My question is: are unvaccinated people more likely to be clustered today than they were decades ago? In other words, has there been an increase in pockets with low vaccination rates, as the article now claims? I’d be interested in seeing evidence of this.

Mary, vaccination rates in the US are relatively stable according to the CDC. The source cited in the Nature article suggests that rates have remained between 87 and 93.6 between 1999 and 2009. Those figures are broken down by “HMO means” and the 90.6 is for “commercial”. The figure for “medicaid” for 2009 is 91.2, which is actually the highest (for medicaid) since 2001. In short, the rates are high and relatively stable.

Mary, a decrease from 2008 to 2009 is a decrease “in my system” too, but it doesn’t necessarily reflect a trend and it doesn’t explain why measles cases are now at a 15-year high. A decade ago (1999-2002) vaccination rates were lower than they are now.

What I’d like to see is evidence that unvaccinated folks are clustered to a greater degree than they were a couple of decades ago. Chris provided examples of outbreaks in the early 90s in religious groups with low vaccination rates. If the unvaccinated tended to be clustered then too and vaccination rates (over the past decade) have been stable and high, to what could we attribute the resurgence?

You really don’t seem to be reading the links I provided (and it seems you did not catch the main point of the Oregon Live article). I only referenced one outbreak that occurred in the 1990s. The others were within the last six years (and the largest was last year).

Please read the sources better, and in the future provide cites for any of your statements.

My apologies, Chris, I’ve been sloppy with my wording – you provided examples of church groups affected by a single outbreak in the 1990s. But again, my question is whether there’s greater clustering of unvaccinated people today than there was in the past. I don’t see anything in the links you’ve provided that would offer evidence that this is the case – church groups and Waldorf schools aren’t recent developments.

While the primary reasons for undervaccination may have changed, it’s not clear that the degree of clustering has. Authors of the paper on the San Diego outbreak state: “During the 1980s and 1990s, undervaccination in the United States was primarily unintentional, associated with diminished access to health care, and was frequently observed among inner-city ethnic or racial minorities, inner-city families living in poverty, and children whose mothers had limited education. Outbreaks attributable to vaccine refusal tended to be observed among religious groups with objections to vaccination (eg, Christian Scientists and the Amish).”
People with diminished access to health care, inner-city ethnic and racial minorities, inner-city families living in poverty, people with lower levels of education, and members of religious groups tend to be clustered. If anything, I’d expect today’s antivaccers to have a looser geographic distribution since the internet seems to play an important role in shaping their attitudes (at least in this study).

“The most significant factor in the spread of measles in the United States is the increase of pockets of the country where vaccination rates have declined below the level needed to maintain herd immunity” is what the article states, and then gives a couple of examples of those areas and posits a cause for them. The examples linked already in this response thread shw other examples of low vax clusters and their causes.

I could say you did not ask it well, but since you were arguing semantics, I don’t think there is any way to answer it to your satisfaction. And personally, I don’t care.

If you think that the authors of the papers failed to ask the right questions, and arrived at an answer you disagree with, then go do your own study. Surely someone you can get funding for that from somewhere.

Chris, I haven’t made a semantic argument, I haven’t made an argument at all. The article claims there’s been an increase in pockets of unvaccinated people and I’ve questioned whether there’s evidence to support this. Neither the existence of pockets now nor their role in outbreaks indicates an increase in their number.

The bigger question on my mind pertains to the reasons for the resurgence of the disease. Why are measles cases now at a 15-year high? Wakefield’s 1998 paper hasn’t noticeably affected vaccination rates in the US. One might speculate that the rates would be higher now if not for his influence, but still, they’re higher than they were a decade ago and a change in the reasons for not vaccinating wouldn’t explain the resurgence.

A greater tendency for today’s unvaccinated individuals to be clustered geographically is a reasonable hypothesis, but I’d like to see some evidence. If we’re going to make claims we can’t support, we might as well blame Wakefield for causing autism while we’re at it.

If you think my reading comprehension is so poor, Chris, why don’t you explain to me how the Oregon Live article provides evidence of an increase in pockets? There are clusters of unvaccinated people today, therefore there must be more clusters than there were a decade ago… is this your reasoning?

Delicious! Absolutely delicious! If you are reading this, Dr. Jay Gordon, please note how close we are coming to a child near you. Keep on discouraging the MMR vaccine, and you just may get a first-hand visit from your favorite DNA virus.

Greg-o, I’d like to point out that you are using the “Dr. Jay” fallacy. You’re putting all people in the denominator. Per Epi Ren, the definition of incidence has the number of new cases in the numerator (the number on top) and the people at risk in the denominator (the number on bottom). Compared to previous years’ incidence rates, yes, it is an enormous outbreak.

It is low due to high rates of vaccination. Without the MMR it would be higher, and there would be a repeat of the years when there were over half a million cases year with hundreds of deaths, plus more being permanently disabled. Obviously you are one of those who cannot learn from history.

Really, there should be no cases, and sometime in the future the measles virus would become extinct. Then the MMR vaccine would be just a bit of history like the smallpox vaccine.

I long to retire to a nice lab somewhere in Atlanta to be catered to my every need with nice baths of broth or other media as scientists marvel at my intricacies… I’m a bit of an exhibitionist, you see.

However, if the anti-vaccine people continue to discourage the vaccine against me, odds are I’ll be making the rounds for some time to come.

What about the more obvious cause of theses outbreaks? I am talking about all the illegals, and third worlders that are allowed in this country. I see examples at the pharmacy all the time. Whole families being treated for all kinds of diseases. Stop the illegals, and unvaccinated from entering this country. France needs to do this, too.

The Somali community in Minnesota is not made up of illegals. The people in this community are here legally. What will you do with the suburban white middle class folks in California who have taken Jenny McCarthy’s advice?

Yikes. Not sure where to start here, but maybe I’ll start with how do you know they’re illegal? (Hint: Speaking a language other than English doesn’t prove anything.) Then…how do you know the whole family is being treated for a disease?

And lastly, and perhaps most relevant for this blog, many outbreaks are caused by people *from* the US who aren’t vaccinated going to another country and coming back with a disease. So maybe we should prohibit travel outside the US?

I don’t think that’s going to fly with most people. Just like the idea of “keeping out the furriners” isn’t going to fly. The US is a country of immigrants, just as it always has been, and we can’t close our borders now.

Also, if you bring up people with Spanish derived names in California, you really need to provide actual evidence they are “illegals” or not descendents of the people who settle there before it was its own republic. The Spanish got there before the Americans.

I think i’d trade 118 cases of measles (of which none had lasting complications or died) for the however many thousands of children who would be vaxxinated and get autism as a result. And before you slam me about autism and vax and the links, I will say that while I do NOT believe there is anything in a vaccine that causes autism, I believe it has something to do with a shock to the system that is caused by the vaccine, not any of the ingredients in it.

So yes, while it is truly terrible that there were 118 cases of measles, I still would go for the trade.

“I believe it has something to do with a shock to the system that is caused by the vaccine, not any of the ingredients in it.”

Why is a vaccine anymore of a shock to the system than an actual infection? Most vaccines contain far less antigenic material than the diseases they are trying to prevent. Even if the amount of antigenic material was equivalent, then one would anticipate that the actual infection is just as likely to cause autism as a vaccine, if your hypothesis is accurate.

Also provide the evidence that the MMR causes autism at a rate greater than the harm caused by measles. The actual disease causes encephalitis in one out of a thousand cases (the resulting brain can be much like autism, or “just” deafness, blindness, etc), and death in about one to three out of a thousand cases. From here:http://jid.oxfordjournals.org/content/189/Supplement_1/S4.full.pdf

It’s about time. His license shluod’ve been revoked years ago. He endangered children for the study and continues to do so to this day. Every year almost 200,000 children die from measles and he told parents to boycott the only thing that can protect them, the MMR vaccine. Why? Because he had something to gain. Meanwhile millions of dollars have been spent on a wild goose chase for autism-vaccine links that could’ve spent actually learning something to help people.It’s absolutely shameful what that man has done in the name of medicine and science.

1. Has it been shown that the unvaccinated patients have refused vaccination because of the autism/vaccination debate? After all, it could have been for another reason (forgot, no access, too poor, etc.).

2. Your reaction seems to be to insist vehemently on vaccination, but I’m not sure that’s the right approach. After all, it’s an issue of trust: “You haven’t figured out why autism happens yet, so why can I trust you on the scary vaccine thing?” Putting resources into figuring out autism seems like the best course of action to me.

Many of these papers are available to read for free, just access them through www. pubmed.gov (the first one is a direct answer to your question, and note the difference between under and un vaccinated):

Pediatrics. 2004 Jul;114(1):187-95.
Children who have received no vaccines: who are they and where do they live?
Smith PJ, Chu SY, Barker LE.

According to the CDC, for all recommended vaccines other than HepB and HepA, children 19-35 months old living below the poverty line have lower vaccination rates than children in families at or above the poverty level.

In the current situation, with more families slipping into poverty and with steep cuts to state budgets, we all need to be sure we are advocating for states to fund the programs that improve affordability and access to vaccines for these vulnerable groups so that the rates of unvaccinated children do not increase.

In the most recent survey (2009), the percentage of children aged 19-35 months receiving no vaccinations was 0.6%. These are probably for the most part kids from families who are anti-vaccination rather than kids from families with an access problem. I think a lot of these anti-vax families are not persuadable and focusing on the families who want vaccines for their kids, but aren’t being successful in getting them, would have better results than focusing on those that reject vaccines.

I believe they are, but people have to know when and where they’re available, they have to be able to get there, etc. So if you’ve got two working parents who don’t know where they’re supposed to take kids for the free shots and can’t afford a doctor, I suspect you get kids who slip through the cracks until it’s time for school.

Getting the word out and making those free shots available at times and places when poor people can find them are definitely good goals.

Decisions about whether to immunize are not usually made rationally nor at one moment in time. And knowledge rarely predicts vaccine uptake — indeed, refusers are more likely to have university education than those who accept vaccination. Hence scientific arguments alone will not sway them, and may even increase their resolve to not immunize.

An unvaccinated 17-year-old girl who was infected with measles on a trip to Romania attended a church picnic in Indiana along with 500 other people, including 35 unvaccinated people. Measles is highly contagious–simply sharing the airspace was enough: Three of the 465 vaccinated guests were infected, while 31 out of the 35 who were unvaccinated contracted the disease. Nobody died, but three people were hospitalized, including one thirty-four year-old who required intubation and ventilator support for six days.

I’m sure it wasn’t intentional, but your description of the outbreak was a little misleading. This is a little more clear.

Approximately 500 persons attended a gathering with the index patient one day after her return home. Approximately 50 lacked evidence of measles immunity, of whom 16 (32 percent) acquired measles at the gathering. During the six weeks after the gathering, a total of 34 cases of measles were confirmed. Of the patients with confirmed measles, 94 percent were unvaccinated, 88 percent were less than 20 years of age, and 9 percent were hospitalized. Of the 28 patients who were 5 to 19 years of age, 71 percent were home-schooled. Vaccine failure occurred in two persons. The virus strain was genotype D4, which is endemic in Romania. Although containment measures began after 20 persons were already infectious, measles remained confined mostly to children whose parents had refused to have them vaccinated, primarily out of concern for adverse events from the vaccine. Seventy-one percent of patients were from four households.

I admit I am one of those who has chosen to forgo vaccinations. I am an educated person but I also have what I consider a healthy level of mistrust when it comes to the medical/pharmaceutical community. My rationale for opting out of vaccinations is that should my child become injured by what I believe to be a vaccine reaction, I’m not allowed to pursue a financial remedy through the courts. Instead I must pursue such remedy through the “Vaccine Injury Compensation Program”. Just browsing the key words in the cases published by the US Court of Federal Claims (where such matters are decided), is enough to give me pause. Some of the claims appear to be denied because the alleged injury was not caused by a vaccine injury itemized in the table of known injuries, the “gimmies,” apparently. So your case can be dismissed not on the merits of evidence or lack thereof, simply because it’s not on the table.

It is a damned if you do, damned if you don’t situation. If I take my chances in giving my kid the vaccines, I’ll be battling the resources of the government to obtain a little financial relief to assist me in caring for my now-disabled child. Doesn’t seem like an easy or inexpensive feat. If I take my chances on not vaccinating, my kid may suffer a disease I may have prevented with vaccines.

So not only is your child at higher risk for infection, but will be asked to stay home when there is an outbreak. Perhaps you ought to review the literature a bit more. Please, use real references (PubMed, your local public health department), and not court cases. There is a difference between legal and scientific evidence.

I’m not sure what you’re suggesting by saying reviewing court cases is not a valid form of research with regard to vaccines. Certainly a review of court cases won’t provide an overall “big picture” but it gives a glimpse into the world of the individual families battling the system for the financial relief which ought to, in my opinion, be allowed to proceed through the regular state and federal court channels. To protect the manufacturers in this way gives them no incentive to improve the safety of the vaccines.

It is no secret that for a small percentage, complications can and do occur. It is part of the literature included with the vaccines that these things can happen. Notwithstanding whether vaccines can be attributed to autism (which is a narrow scope of the injuries that could occur), there are other known risks, including death, for a small percentage of those who receive the vaccines.

The percentages to compare in my mind is what is the percentage of people who acquire a vaccine preventable disease vs. percentage of people who are injured by the vaccines. It’s a game of odds.

If parents don’t want to pursue a case in the Vaccine Court – they still have the option to sue in regular court, but remember the standards of evidence are much higher there (and much more expensive to litigate).

“If I take my chances on not vaccinating, my kid may suffer a disease I may have prevented with vaccines.”

The disease, and possible ensuing death or disability, is only half the risk of not vaccinating. The other half is that your child may then put other people at risk of infection, such as babies who are themselves too young to receive the vaccines in question, immunocompromised people (e.g. Leukaemia patients) etc. No man is an island sufficient unto himself.

The widely cited idea of “herd immunity” is incorrect. A vaccinated person CAN still carry a virus in their airways, nasal passages etc. Therefore, a vaccinated individual can still put an unvaccinated infant at risk of exposure.

I am on the fence with vaccinations. My two oldest children have had the full rounds of vaccines, as I just did what I thought I supposed to do. However, after doing a little research, I am concerned about the possible links between some vaccines and certain neurological and autoimmune diseases. My oldest daughter has Type 1 diabetes which MAY (and I stress MAY) have links to the MMR vaccine. The vaccine pamphlet itself states this risk. It is this information and other research I have studied that has caused me to investigate further and educate myself on the risks of exposure vs. risk of side effects of vaccines.

My issues with the comments in these threads is that anyone who clearly states an anti-vaccine opinion is shot down as either (A) a competitive house Mom who just willy nilly makes a decision to stand out or be radical or (b) someone who is crazy and an uneducated public menace to society. I am neither, and am just doing what I feel is the best interest of my child: researching BOTH sides and making an informed decision about what is best for the health of my child.

The widely cited idea of “herd immunity” is incorrect. A vaccinated person CAN still carry a virus in their airways, nasal passages etc. Therefore, a vaccinated individual can still put an unvaccinated infant at risk of exposure.

Citation, please.

Especially for vaccines like the DTaP and Hib, which are for bacterial diseases. And also the HepB vaccine which uses only an engineered protein from yeast.

The oral polio vaccine that is no longer used in the USA, and the vaccinia vaccine for smallpox that is only given to certain people are the only vaccines that I know shed viruses. I would really like you to point out the documentation that I can find in my local medical school library that shows that the MMR, IPV, and other viral vaccines can cause secondary infections in other people.

I believe that in order to make a well informed decision, you cannot rely SOLELY on medical journals and publications. I am not a conspiracy theorist by any means, but there is proven corruption and conflict of interest with many medical journals (DSM for one) and big pharma.

I want to stress again, that I am NOT anti-vaccine, but just trying to raise questions that I feel have not been raised or adequately researched. I am open to ALL information and I appreciate the research Chris and others have provided here. It is only my goal to make an informed decision and not one based on fear mongering, or that my hand “be forced” so-to-speak to make health decisions for my family based on individuals making me feel ignorant or morally in superior for asking questions. Does that make sense?

Also, it is impossible to read the Mercola article with the ad to sign up for his newsletter plastered in front the words. I have no interest in signing up for his newsletter, nor in buying any of his supplements.

So please tell me what actual scientific evidence you have that the MMR vaccine can shed virus, and really really need to know how the DTaP and Hib vaccines spread virus. I would be grateful because I keep seeing folks make that claim, but they never tell give any evidence. Thank you.

I consider Mercola to be a very unreliable source, not primarily because he’s not actually a medical doctor, but because he’s also anti-sunscreen, anti-microwave cooking, an AIDS denialist (!) and a touter of dubious, largely untested food supplements.

But enough of considering the source, let’s look at his argument. From the page you link, it pretty much stops at “outbreaks have occurred in vaccinated populations.” And that’s weak. No specific comparison of case numbers in vaccinated and unvaccinated populations, no definition of what proportion of a population have to be vaccinated to qualify, etc. No consideration of the clinical trial evidence either, which is the gold standard visavis answering the question of “what does this intervention actually do”.

And of course, no acknowledgement whatsoever of vaccination’s successes, such as the total eradication of Smallpox and Rinderpest.

Actually he is a licensed osteopathic physician, which if very much like an MD. Except he has found it more lucrative to push his supplements by scaremongering.

Using “View Source” and a bit of fiddling with the website html I found it was an old article written by Alan Phillips, lawyer in North Carolina. On that page you will see a link to his “Dispelling Vaccination Myths” that I first read more than ten years ago (when he was in law school).

A few years after being introduced to Alan Phillips (and John Scudamore of whale.to fame) I encountered an article about Mr. Phillips “facts.” It was the first version of The Anti-Immunization Activists: A Pattern of Deception. You will see that Mr. Phillips’ list of “myths” is the first set of sites shown to have issues with veracity.

My favorite lie that keeps popping up is that Japan stopped vaccinating for pertussis and there was no more SIDS. Actually there were, it is just that they could no longer blame the vaccine. A pertussis vaccine was reinstated when the deaths from pertussis were increasing.

I believe that “momofthree” needs to update her researching skills, or at least learn how to vet sources . First hint that a site is dodgy is that they sell their own special products. Of course, it doesn’t help she did not notice that the Mercola page was ten years old.

And I really do want to see what vaccines in the present pediatric schedule have been shown to be transmissible to others because of virus shedding. And not just a list, but the studies showing that it is a common occurrence.

Again, citation please. We have clear experimental evidence for herd immunity from cluster-randomised clinical trials (although, admittedly, these have not been done with all vaccines) in which in group A clusters, everyone is given the vaccine, in group B clusters, some are given the vaccine and some are not, and in group C clusters, nobody is given the vaccine. You can then measure the herd immunity effect by how much the incidence has been reduced in unvaccinated individuals in group B clusters.

Let’s take some of the diseases vaccinated against. Meningococcal vaccine, for instance. Invasive Meningococcal Disease has a lifetime risk of about 1 in 1,000, and kills about 1 in 10 patients. So a risk of death of 1 in 10,000 (plus a disability risk whose magnitude I don’t know). Therefore it’s worth having the vaccine.

Similarly, Measles. Lifetime risk is less clear, because it isn’t obvious what the chances are of it coming back to the USA (assuming that’s where you’re from) in a big way, but the combined chance of death or disability from infection is about 1 in 1,000. Therefore, any lifetime risk greater than 1 in 1,000 of catching measles would make it worthwhile having the vaccine.

And all of that, of course, is before the added protection against passing on the disease to others, ignoring the immediate burden of disease involved in catching something really horrible and being sick for a while, and ignoring non-disabling long term sequelae of infection.

This study has much more in it that reported by the writer. If only it were as simple as the writer wants it to be. The degree of severity and the rates in which people are infected by measles is greatly affected by their genetic background. To most Europeans the disease can hardly be categorized as serious much less life threatening. yet to Mexicans and native south Americans, the disease can be very serious. Hence you need to look more at the detail in the study and look into migration patterns. The french cases are strongly in the the Muslim and Algerian communities which are growing in the country.

As far as autism, The rate of autism has been growing steadily in the U.S. and it’s onset is often linked to vaccinations. Although no positive proof yet exists there definitely is a smoking gun there. The thought that vaccinations are ‘shocks’ to the system, is a theory, but to compare the measles vaccination to actual measles in this case is wrong. The measles vaccination commonly comes with a mumps and rubella vaccination, in addition to a host of other chemicals deposited directly into the individual, including now in some vaccines, aborted fetal tissue, thus introducing foreign human DNA into the body. This could easily be seen as more shocking then exposure to a single virus.
To medical science vaccines are the same as communion to Catholics, Not to put down Catholics, They receive communion because they believe in what it is. This is the same for the medical people. They believe that vaccines are the cornerstone of medical health, thus the strong bias and inept reporting on their side.

Do you have any evidence to support your contention on a genetic/ethnic link to susceptibility to severe disease with measles, or is this just speculation?

As to your other contentions:
- The alleged autism link has been looked at again and again with no sign of any supporting evidence, and no difference in the autism rates between unvaccinated people, people receiving combined MMR vaccine, and people receiving individual M, M and R vaccines.
- “Fetal tissue” comes nowhere near vaccines – the weakened viruses which are used in live vaccines, such as measles, are cultured in cell lines in laboratories, not in organs and tissues. You can read more about this here, if you like: http://www.drwile.com/lnkpages/render.asp?vac_abortion.
- The Mumps and Rubella viruses are also well worth avoiding. Mumps carries a real risk of meningitis, of damage to the reproductive organs (ovaries in women, and testes in men), and of inducing miscarriage in pregnancy. Rubella, meanwhile, carries a risk of causing serious congenital defects if a woman catches it while pregnant, and we have to vaccinate men as well as women to ensure herd immunity.

And no, vaccines are not trusted in religiously. They’re used on the basis of proof through clinical trials, through their observed long-term impact after implementation, and through careful monitoring for adverse events (with the identification of real issues not being made any easier by scare stories and misinformation). With vaccines, we’ve now eradicated both smallpox, and measles’ closest known cousin, rinderpest. We’ve reduced the rates of diseases like measles to vanishingly small quantities (in rich countries, anyway). And I don’t think it’s unreasonable to argue that these changes are a good thing.

Thank you for getting this information out there. We have so many friends who have chosen not to vaccinate that it sometimes makes me feel like I’m crazy for being mainstream. The benefits of vaccination seem to far out-way the risks. I’d like to thank my fantastic Silver Spring, Maryland physician, Dr. Janet Adams, for insisting on sticking to the vaccine schedule.

Ok, Chris…you are very inflammatory, brow beating and self-righteous in your comments/attacks. You and your “PUB MED” insistences are annoying and a turn off to anyone who may have been willing to listen to your reasoning/point of view. I am always open to factual information such as what you reference, however your TONE and ATTITUDE make me cringe. You attacking people is not helping your cause so good luck with that.

Thank you to the others who have provided me links and information to support vaccination with a gentle, non-judgmental spirit. You have been very helpful.

I am sorry that asking for references seems to be considered rude in your book. I tried to be as polite as possible, but it is difficult when you did not answer the question. I did try to show you an example of actual evidence to be helpful, but you linked to a subscription only webpage that dated back to 2001. So I assumed you did not fully read my comment.

If I attacked anyone it was Alan Phillips for his less than truthful list of “vaccine myths”, and Dr. Mercola for requiring a subscription to read his website, plus the fact he sells stuff on that site. I did not attack you for linking to them, but tried to explain why they are not reliable sources of information.

If you are going to make statements like “vaccines shed virus” you should be able to back them up, and not get offended when your are asked for evidence. Or if your sources are questioned. And really, please, tell us which vaccines in the present pediatric schedule are know to be infectious for a certain amount of time and where you accessed this information. You can either answer the question, or simply state “I don’t know, and might be wrong.”

Also, please tell me why you object to http://www.pubmed.gov, an index of medical journals/papers. It is easy to search, and does have a filter to access the papers that are free to read online without a subscription. If you do not like a website where medical research from around the globe is available, can you please tell me your preferred method of doing research?